State of the Faculty Address 2017

One hundred and thirty years is a long time, especially in rapidly developing China that had experienced in that historical space dynastic rule, foreign occupation and concessions, republican revolution, civil war, foreign invasion, founding of the modern state, internal struggles, economic liberalisation, and more recently national rejuvenation and emerging geopolitical leadership. One constant, amongst few others, during the past century and some has been our school, variously called the Hong Kong College of Medicine for Chinese, Hong Kong College of Medicine, Faculty of Medicine of The University of Hong Kong, and since 2005 Li Ka Shing Faculty of Medicine. Not only were we by far the oldest local tertiary institution, we are the third school of western medicine established in the country (after Boji Medical College, forerunner of present-day Sun Yat-Sen University Zhongshan School of Medicine founded in 1866, and Peiyang (or Bei Yang) Medical College in Tianjin that was first inaugurated as the Viceroy’s Hospital Medical School in 1881). We also boast an uninterrupted history since our founding.

Fast forward from 1887 to today, where are we? Notwithstanding the many imperfections of ranking exercises, and at the risk of sounding unmannerly, I am pleased to report that we are ranked third in Asia by both QS and Times Higher Education, or 34th and 31st in the world respectively. Nationally, an affiliate of the Chinese Academy of Social Sciences recently ranked Queen Mary Hospital, our flagship teaching hospital for 80 years and counting, third in the country after the People’s Liberation Army 301 Hospital and Peking Union Medical College Hospital, both in Beijing.

With our legacy and present achievements, where are we heading? The equivalent Latin expression quo vadis entitled the late Professor Sir David Todd’s Halnan Lecture celebrating the inauguration of the Hong Kong Academy of Medicine complex almost two decades ago in 1998. Here and now, as we enter the first day of the fifth month in mourning Sir David’s passing, I ask again the reflective question he then posed. In attempting an answer, I take the opportunity to summarise the work of the Deanery during the past five years while sketching a vision for the next decade.

Foremost, our priority has always been to plan for the future of our graduates, and by extension that of generations of patients here and everywhere. We set our sights not just on next year’s rankings or the Research Assessment Exercise in 2020, rather we take a long term view as the Norman Ko sculpture at the steps of the University’s East Gate reminds us –十年樹木，百年樹人– that in education we must plan for the next century.

President Xi Jinping in a landmark address last August set out the country’s vision in health and health care. The State Council followed with the publication of Healthy China 2030, a national blueprint of population health development. In parallel, China has recently embarked on the ambitious “Belt and Road” geopolitical initiative that will define the coming era of global development. Yesterday therefore we held a summit of global health leaders, many of whom have joined the platform procession this afternoon, to kickstart a dialogue on what all this may mean for health sciences education, research and innovation in biomedicine, the dissemination and application of cutting-edge technologies at the bedside and in patients’ homes in this region where one-fifth of humanity lives and beyond. This will very much frame much of what we will do in future and provide the basis for a series of impactful multilateral collaborations.

As 大學 or The Great Learning, one of the Confucian classics from which the University took its motto, emphasises, to be truly effective on the national or global stage, one must first put affairs of self and at home in good order, that is 修身、齊家. We have begun to mend and expand our home on Sassoon Road, extending to the clinical campus of the Hong Kong West Cluster jointly with the Hospital Authority, and across the border at our mainland base.

In 2014, the School of Public Health’s erstwhile disparately located offices reunited in the refurbished Patrick Manson Building (South Wing) at 7 Sassoon Road, in a fitting tribute to Sir Patrick’s memory as our founding dean and public health icon. The South Wing of the Patrick Manson complex has become an extension of the Madam SH Ho Residence for Medical Students, adding 124 places or 43% more capacity to the housing stock for students in their clinical years.

Across the road at 8 Sassoon Road, construction works are about to begin on the Laboratory Animal Unit capital works upgrade. When the project is completed by the end of 2020, it will provide an additional 730m2 or one-third more net operating floor area for the only AAALAC1-accredited facility in southern China.

Two major new buildings have recently been approved to be constructed on Tang Court at 21 Sassoon Road and on the old laundry site at 3 Sassoon Road, both hopefully to be completed by 2021. The former project will see the addition of 2,800m2 of conference facilities and administrative offices consolidated in the new three-storey Annex. The winning design comes from Wong and Ouyang, whose principal is a distinguished Architecture alumnus previously responsible for the acclaimed Centennial Campus Project. As a consequence, the entire William Mong Block will be refurbished and reserved for student learning and amenities, housing amongst others the Bau Institute for Medical and Health Sciences Education and the Learning Commons @Medicine.

No. 3 Sassoon Road will provide a new permanent home for the School of Nursing as well as expanded quarters pro tem for the School of Chinese Medicine, together accounting for over 10,000m2 of net floor area in the nine-storey building that will be connected by footbridges with Queen Mary Hospital across Pokfulam Road, student residences at 6 Sassoon Road and the Jockey Club Building for Interdisciplinary Research on 5 Sassoon Road.

We have invested and attracted external funding totalling some HKD1.5 billion for these Sassoon Road capital projects.

We have also been making parallel expansion plans at our teaching hospitals. Our pathology and microbiology departments are currently moving into newly refurbished laboratories, including a state-of-the-science biosafety level 3 facility, at the converted Block T of Queen Mary Hospital. Before these laboratory-based clinical departments find a purpose-built home in phase 2 of the Queen Mary redevelopment after 2024, the present premises provide over 2,100m2 more operating space than the University Pathology Building which will be demolished to make way for phase 1 clinical expansion and reprovisioning.

Next, in tandem with the redevelopment of Grantham Hospital into Hong Kong’s first academic cancer centre by 2024, we were awarded the University’s largest single donation to date by the Hong Kong Jockey Club Charities Trust of HKD1.24 billion. Together with government’s co-investment altogether totalling almost HKD3.8 billion, we will be building and fitting out a new translational research block of about 15,000m2 at Grantham Hospital to bring –omics and cell-based technologies to bear on advancing the frontiers of cancer patient care.

Finally, at the HKU-Shenzhen Hospital, we will be constructing a research block of 27,000m2 to accelerate our growth into a truly academic health science centre there.

On completion, these projects together will more than double the Faculty’s net operating floor area for teaching and research, thereby restoring the per capita space norm for every student and researcher at the turn of the millennium.

In the coming decade, we will be relentless in further pursuing opportunities to continue the Sassoon Road medical campus transformation mega project, from Pokfulam Road at the top to Victoria Road at the bottom. We have already begun the second-phase master campus planning process with the vision to redevelop the current site of the Estates Building and its neighbouring reservoir to rehouse and consolidate the School of Public Health’s laboratories, classrooms and offices under one roof. Across the road then, as a final step of the Sassoon Road transformation, the Patrick Manson site (including both the North and South wings) would become the new home of Pharmacy and Pharmacology, which by that time would hopefully have achieved “School” status. The School of Chinese Medicine would also be re-located to share this site with the pharmacists and pharmacologists.

While the built environment is a critical input for excellence, it must take second place in relation to our people strategy. I am again most pleased to report the brilliant successes our colleagues have enjoyed in the past year. There are simply too many to recount here and now although I would refer you to the printed proceedings for a complete listing.

We must not rest on our laurels, of course. Let me give an overview of how we continue to enhance human capital at the Faculty. By the numbers, since 2013, we have increased the size of our professoriate by 9%, the strength of our research staff by 12% and the number of endowed professorships by 50%. Following the overarching strategy of differentiation in the professoriate categories of the University, we have ambitiously and aggressively recruited the most brilliant minds, from heads of schools and departments to world-leading researchers.

Like most of our national and international peers, many of their leaders are sitting behind me, the Faculty seeks to expand and improve our human capital stock of clinician-scientists. In parallel to intensifying recruitment externally, we are hopeful that the new Enrichment Year of our MBBS programme will inspire and initiate more students into joining our ilk. Recent support from the Li Shu Pui Medical Foundation, Croucher Foundation and the Health and Medical Research Fund Fellowship Scheme has lent a useful boost to recruiting junior clinical academics. Given the Chief Executive’s espoused goal of turning Hong Kong into an innovation and technology hub, not least with a special emphasis on biomedicine, we look to the relevant bureaux for a renewed, era-defining push. This of course goes beyond financial support. Even more importantly, we need to align non-monetary incentives amongst the Hospital Authority as the exclusive employer of virtually all trainees, the Academy Colleges whose training guidelines have become progressively more systematised but perhaps inadvertently inflexible, and mea culpa the universities which are myopically obsessed with short-term results to satisfy the alphabet soup of RAE, QAC and UAA imposed by the University Grants Committee. The value placed on nurturing clinician-scientists must be genuinely reflected in a fundamental sea change in multi-institutional attitude that is followed through to action. This is a collective test of whether transformational leadership is matched by transactional leadership to bring about real change.

Once budding clinician-scientists are in post, like any good gardener the Faculty must nurture them and help them flourish. 十年樹木，百年樹人 – whereas the terms and conditions of service for clinical academics used to be superior to government doctors when I first joined the Faculty, the reverse had until recently been true. Remuneration is now on par although medical benefits remain less favourable. The notional workload allocation of 55% clinical duty for clinician-scientists, as well as 10% teaching and research responsibility for Hospital Authority staff at the teaching hospitals must be universally respected and robustly enforced. Even for superstars, the day only spans 24 hours.

To support our academic colleagues, we have made a determined effort to bolster the administrative establishment. They have for far too long been an afterthought, although anyone who works in universities will tell you that they are actually the people who make the whole place tick. Of course, as a mostly publicly funded institution, we must be accountable for justifying this overdue expansion of our support infrastructure. Here the Executive Vice President’s SMARTER@HKU programme provides a timely complement, identifying and implementing efficiency improvements to finance this and other initiatives.

On research and discovery, our philosophy has always been to provide the best hardware and software infrastructure, within a flexible and facilitative environment, to a community of the most brilliant minds then leave them to work their innovative magic. In particular the research deanery constantly reminds itself that the best laid plans rarely pan out and that scientific serendipity springs from curious and wandering minds. Managers of research must desist from actually managing research, rather positive non-interventionism must be our guide after having satisfied the most robust and stringent ethical and fiduciary oversight.

Therefore, we have focused on expanding core technology platforms particularly growing our –omics capabilities, small animal competencies and clinical trials facilities. To complement the investment in facilities and equipment, we continue to grow our core expertise in bioinformatics, biostatistics and clinical research methodologies. More recently, in tandem with the territory-wide shift towards a more entrepreneurial orientation in biomedical research, and inspired by the demonstrated success of Shenzhen in the digital economy as well as for startups generally, members of the Faculty have also engaged more deeply and frequently with industrial partners in co-developing devices, new vaccination strategies and the like.

Over the past decade and a half, the Faculty has matured from designating virtual research hubs and nurtured them into internationally recognised centres of excellence. The coming decade will hopefully see further consolidation in our lead in these areas of infection, cancer, biopharmaceuticals, stem cell and developmental biology, and global health. We also anticipate the emergence of newer fields that perhaps we cannot yet foresee. As such our research policy will always remain nimble and proactive in supporting nascent as well as established areas of enquiry.

One of the most exciting projects of our 130th anniversary is the MBBS 130 curriculum. The centrepiece is of course the Enrichment Year. Essentially it is our response, as a school practising undergraduate medical entry, to reap the benefits of a graduate entry system wherein incoming students would already have had a more broadly based and varied set of exposures at the tertiary level. At the same time it also lends the opportunity for aspiring students to pursue research, without the immediate time penalty associated with a more conventional MD-PhD track at enrolment. Furthermore, this Year is particularly important for the relatively much younger (compared to the case in North America and other graduate entrants in the UK and Australia) and really high-performing students in our context. The restrictive licensing regime in place since repatriation in 1997 has effectively made supply much less flexible thus wages disproportionately higher and therefore entry into the profession even more competitive, while at the same time all aspiring students converge on the two local schools. The Enrichment Year gives them the broadening worldview and an outlet for their tremendous energy to learn. It is a truly innovative experiment as I am unaware of another school that has tried such an approach. I hope to share our experience, that is failures as well as successes, more widely with colleagues around the world as we move forward, and in turn learn from our peers how to constantly improve our curricular offering.

I am also very proud of the success of our BBiomedSc programme, that has over the last five years become one of the most desired choices for high school leavers with entrance scores just shy of our flagship MBBS course. Of particular note, the exchange cum articulation with Edinburgh, Sydney and UC Berkeley in veterinary surgery, physiotherapy, radiography and public health have proved a major attraction. I thank their respective leaders for joining us in the platform party this afternoon.

To enhance pastoral care, together with the various student societies, we have jointly appointed two social workers to improve student wellbeing, to provide support and to intervene at the earliest signs of distress. There is to be a “China wall” in the work of these colleagues who are explicitly instructed not to divulge confidential information to the Faculty so as to create and maintain a safe environment for students to freely share their feelings and thoughts. We continue to look for a full-time clinical psychologist to join this team.

The impact of our human capital development work radiates into the mainland, which has just launched the so-called “5+3+X” residency training reform initiative. Having presided over the Hong Kong Academy of Medicine since its founding by Sir David Todd a quarter of a century back, albeit on an ad personam basis by our professoriate colleagues, we have accrued much hard-earned experience to offer the rest of the country. To this end, I am pleased to report that HKU Health System with its four constituent teaching hospitals officially became a member of the Chinese Consortium of Elite Teaching Hospitals for Residency Education, leaders of each of the other eight academic health sciences centres are here with us in the procession. This marks a historical milestone of Hong Kong’s deep re-engagement with the mainland through our professional contribution. Not only can we share lessons we have learned through this process, we can also ensure that our own training scheme will be compatible as the country’s fledgling system matures. This could guarantee portability of our specialist qualifications nationwide that would extend beyond 2047. Just as Sir David had the foresight to build Hong Kong’s own specialist training regime to ready ourselves for 1997, we are now coming full circle to become nationally accredited as we approach 2047 when today’s graduands will be at their prime.

On the subject of deep engagement with the national health system, HKU-Shenzhen Hospital is our bridgehead. Let me take this occasion to congratulate it on the double happiness of having just been certified as the newest “3A” hospital in Guangdong province as well as designated an officially recognised residency training site by the national ministry. Accomplishing either feat would have been remarkable, let alone both within the short span of five years since commissioning. Its financial health has also improved to the extent that its operating budget, importantly inclusive of the HKU service contract, is now balanced.

I began my report by citing the first two elements of The Great Learning, which were 修身、齊家 (perfecting oneself and one’s family). Now I should like to end my presentation by recalling the remaining two elements of 治國、平天下 (leading the country and the world). I dare not suggest that we would really be first amongst equals with our national and international peers. Suffice that HKU remains open to global interconnectedness, as a lynchpin in southern China and through the renewed Sea Silk Road to the rest of the world. We have done much to prepare ourselves. We boast four State Key Laboratories partnered with leading mainland institutions. We are also the Asian hub of Institute Pasteur with the HKU-Pasteur Pole and Karolinska Institutet’s first international foray with the Dr Li Dak Sum HKU-Karolinska Centre in Regenerative Medicine. Both the director and president of these respective esteemed institutions are also on stage. We are the exclusive clinical partner of Asia’s largest hospital group, Parkway Pantai, viz Gleneagles Hong Kong which began operations in March this year. At the global level, we host a WHO Reference Laboratory for Influenza and a WHO Collaborating Centre for Infectious Disease Epidemiology and Control. The list goes on.

In keeping with Hong Kong’s history, we are at our best when we are open, welcoming and collaborative with the world. Especially during the present inward-looking age of nationalistic isolationism and even tribalism, the Faculty of Medicine declares ourselves a global citizen, a friend to our profession worldwide and a voice for all humanity.

My first predecessor, Sir Patrick Manson in his remarks at the inauguration of the Hong Kong College of Medicine for Chinese on October 1, 1887 said:

…The old Greek cities used to boast of their great men, and claim them with jealous care. Let us hope that in the new and greater China of the future, when the learned dispute of their great men, not a few may be claimed for Hongkong and for the school to-day inaugurated…

I am content that we have done his words justice. And so today I say to you:

New cities along the Belt and Road will benefit from the wisdom, compassion and commitment of our graduates, from generation to generation. Let us pray that in the renewed globalism of tomorrow’s world, when the people consider leaders of clinical medicine to planetary health, more than a few may be claimed for Hong Kong and for the faculty today celebrated.

1 Association for Assessment and Accreditation of Laboratory Animal Care International